Survival after antireflux surgery versus medication in patients with reflux oesophagitis or Barrett's oesophagus: multinational cohort study

Research output: Contribution to journalJournal articlepeer-review

Standard

Survival after antireflux surgery versus medication in patients with reflux oesophagitis or Barrett's oesophagus : multinational cohort study. / Yanes, M.; Santoni, G.; Maret-Ouda, J.; Ness-Jensen, E.; Farkkila, M.; Lynge, E.; Pukkala, E.; Romundstad, P.; Tryggvadottir, L.; Chelpin, M. Von Euler; Lagergren, J.

In: British Journal of Surgery, Vol. 108, No. 7, 2021, p. 864-870.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Yanes, M, Santoni, G, Maret-Ouda, J, Ness-Jensen, E, Farkkila, M, Lynge, E, Pukkala, E, Romundstad, P, Tryggvadottir, L, Chelpin, MVE & Lagergren, J 2021, 'Survival after antireflux surgery versus medication in patients with reflux oesophagitis or Barrett's oesophagus: multinational cohort study', British Journal of Surgery, vol. 108, no. 7, pp. 864-870. https://doi.org/10.1093/bjs/znab024

APA

Yanes, M., Santoni, G., Maret-Ouda, J., Ness-Jensen, E., Farkkila, M., Lynge, E., Pukkala, E., Romundstad, P., Tryggvadottir, L., Chelpin, M. V. E., & Lagergren, J. (2021). Survival after antireflux surgery versus medication in patients with reflux oesophagitis or Barrett's oesophagus: multinational cohort study. British Journal of Surgery, 108(7), 864-870. https://doi.org/10.1093/bjs/znab024

Vancouver

Yanes M, Santoni G, Maret-Ouda J, Ness-Jensen E, Farkkila M, Lynge E et al. Survival after antireflux surgery versus medication in patients with reflux oesophagitis or Barrett's oesophagus: multinational cohort study. British Journal of Surgery. 2021;108(7):864-870. https://doi.org/10.1093/bjs/znab024

Author

Yanes, M. ; Santoni, G. ; Maret-Ouda, J. ; Ness-Jensen, E. ; Farkkila, M. ; Lynge, E. ; Pukkala, E. ; Romundstad, P. ; Tryggvadottir, L. ; Chelpin, M. Von Euler ; Lagergren, J. / Survival after antireflux surgery versus medication in patients with reflux oesophagitis or Barrett's oesophagus : multinational cohort study. In: British Journal of Surgery. 2021 ; Vol. 108, No. 7. pp. 864-870.

Bibtex

@article{01cbebc8cd0748889ef006e59f7e3249,
title = "Survival after antireflux surgery versus medication in patients with reflux oesophagitis or Barrett's oesophagus: multinational cohort study",
abstract = "Y Background: The aim was to examine the hypothesis that antireflux surgery with fundoplication improves long-term survival compared with antireflux medication in patients with reflux oesophagitis or Barrett's oesophagus.Method: Individuals aged between 18 and 70 years with reflux oesophagitis or Barrett's oesophagus (intestinal metaplasia) documented from in-hospital and specialized outpatient care were selected from national patient registries in Denmark, Finland, Iceland, and Sweden from 1980 to 2014. The study investigated all-cause mortality and disease-specific mortality, comparing patients who had undergone open or laparoscopic antireflux surgery with fundoplication versus those using antireflux medication. Multivariable Cox regression analysis was used to estimate hazard ratios (HRs) with 95 per cent confidence intervals for all-cause mortality and disease-specific mortality, adjusted for sex, age, calendar period, country, and co-morbidity.Results: Some 240 226 patients with reflux oesophagitis or Barrett's oesophagus were included, of whom 33 904 (14.1 per cent) underwent antireflux surgery. The risk of all-cause mortality was lower after antireflux surgery than with use of medication (HR 0.61, 95 per cent c.i. 0.58 to 0.63), and lower after laparoscopic (HR 0.56, 0.52 to 0.60) than open (HR 0.80, 0.70 to 0.91) surgery. After antireflux surgery, mortality was decreased from cardiovascular disease (HR 0.58, 0.55 to 0.61), respiratory disease (HR 0.62, 0.57 to 0.66), laryngeal or pharyngeal cancer (HR 0.35, 0.19 to 0.65), and lung cancer (HR 0.67, 0.58 to 0.80), but not from oesophageal cancer (HR 1.05, 0.87 to 1.28), compared with medication, The decreased mortality rates generally remained over time.Conclusion: In patients with reflux oesophagitis or Barrett's oesophagus, antireflux surgery is associated with lower mortality from all causes, cardiovascular disease, respiratory disease, laryngeal or pharyngeal cancer, and lung cancer, but not from oesophageal cancer, compared with antireflux medication.",
keywords = "GASTROESOPHAGEAL-REFLUX, DATA QUALITY, RISK-FACTOR, DISEASE, REGISTRY, FUNDOPLICATION, EPIDEMIOLOGY, MORTALITY, TRIAL",
author = "M. Yanes and G. Santoni and J. Maret-Ouda and E. Ness-Jensen and M. Farkkila and E. Lynge and E. Pukkala and P. Romundstad and L. Tryggvadottir and Chelpin, {M. Von Euler} and J. Lagergren",
year = "2021",
doi = "10.1093/bjs/znab024",
language = "English",
volume = "108",
pages = "864--870",
journal = "British Journal of Surgery",
issn = "0007-1323",
publisher = "JohnWiley & Sons Ltd",
number = "7",

}

RIS

TY - JOUR

T1 - Survival after antireflux surgery versus medication in patients with reflux oesophagitis or Barrett's oesophagus

T2 - multinational cohort study

AU - Yanes, M.

AU - Santoni, G.

AU - Maret-Ouda, J.

AU - Ness-Jensen, E.

AU - Farkkila, M.

AU - Lynge, E.

AU - Pukkala, E.

AU - Romundstad, P.

AU - Tryggvadottir, L.

AU - Chelpin, M. Von Euler

AU - Lagergren, J.

PY - 2021

Y1 - 2021

N2 - Y Background: The aim was to examine the hypothesis that antireflux surgery with fundoplication improves long-term survival compared with antireflux medication in patients with reflux oesophagitis or Barrett's oesophagus.Method: Individuals aged between 18 and 70 years with reflux oesophagitis or Barrett's oesophagus (intestinal metaplasia) documented from in-hospital and specialized outpatient care were selected from national patient registries in Denmark, Finland, Iceland, and Sweden from 1980 to 2014. The study investigated all-cause mortality and disease-specific mortality, comparing patients who had undergone open or laparoscopic antireflux surgery with fundoplication versus those using antireflux medication. Multivariable Cox regression analysis was used to estimate hazard ratios (HRs) with 95 per cent confidence intervals for all-cause mortality and disease-specific mortality, adjusted for sex, age, calendar period, country, and co-morbidity.Results: Some 240 226 patients with reflux oesophagitis or Barrett's oesophagus were included, of whom 33 904 (14.1 per cent) underwent antireflux surgery. The risk of all-cause mortality was lower after antireflux surgery than with use of medication (HR 0.61, 95 per cent c.i. 0.58 to 0.63), and lower after laparoscopic (HR 0.56, 0.52 to 0.60) than open (HR 0.80, 0.70 to 0.91) surgery. After antireflux surgery, mortality was decreased from cardiovascular disease (HR 0.58, 0.55 to 0.61), respiratory disease (HR 0.62, 0.57 to 0.66), laryngeal or pharyngeal cancer (HR 0.35, 0.19 to 0.65), and lung cancer (HR 0.67, 0.58 to 0.80), but not from oesophageal cancer (HR 1.05, 0.87 to 1.28), compared with medication, The decreased mortality rates generally remained over time.Conclusion: In patients with reflux oesophagitis or Barrett's oesophagus, antireflux surgery is associated with lower mortality from all causes, cardiovascular disease, respiratory disease, laryngeal or pharyngeal cancer, and lung cancer, but not from oesophageal cancer, compared with antireflux medication.

AB - Y Background: The aim was to examine the hypothesis that antireflux surgery with fundoplication improves long-term survival compared with antireflux medication in patients with reflux oesophagitis or Barrett's oesophagus.Method: Individuals aged between 18 and 70 years with reflux oesophagitis or Barrett's oesophagus (intestinal metaplasia) documented from in-hospital and specialized outpatient care were selected from national patient registries in Denmark, Finland, Iceland, and Sweden from 1980 to 2014. The study investigated all-cause mortality and disease-specific mortality, comparing patients who had undergone open or laparoscopic antireflux surgery with fundoplication versus those using antireflux medication. Multivariable Cox regression analysis was used to estimate hazard ratios (HRs) with 95 per cent confidence intervals for all-cause mortality and disease-specific mortality, adjusted for sex, age, calendar period, country, and co-morbidity.Results: Some 240 226 patients with reflux oesophagitis or Barrett's oesophagus were included, of whom 33 904 (14.1 per cent) underwent antireflux surgery. The risk of all-cause mortality was lower after antireflux surgery than with use of medication (HR 0.61, 95 per cent c.i. 0.58 to 0.63), and lower after laparoscopic (HR 0.56, 0.52 to 0.60) than open (HR 0.80, 0.70 to 0.91) surgery. After antireflux surgery, mortality was decreased from cardiovascular disease (HR 0.58, 0.55 to 0.61), respiratory disease (HR 0.62, 0.57 to 0.66), laryngeal or pharyngeal cancer (HR 0.35, 0.19 to 0.65), and lung cancer (HR 0.67, 0.58 to 0.80), but not from oesophageal cancer (HR 1.05, 0.87 to 1.28), compared with medication, The decreased mortality rates generally remained over time.Conclusion: In patients with reflux oesophagitis or Barrett's oesophagus, antireflux surgery is associated with lower mortality from all causes, cardiovascular disease, respiratory disease, laryngeal or pharyngeal cancer, and lung cancer, but not from oesophageal cancer, compared with antireflux medication.

KW - GASTROESOPHAGEAL-REFLUX

KW - DATA QUALITY

KW - RISK-FACTOR

KW - DISEASE

KW - REGISTRY

KW - FUNDOPLICATION

KW - EPIDEMIOLOGY

KW - MORTALITY

KW - TRIAL

U2 - 10.1093/bjs/znab024

DO - 10.1093/bjs/znab024

M3 - Journal article

C2 - 33724340

VL - 108

SP - 864

EP - 870

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - 7

ER -

ID: 276447505